Online Therapy - Studies Show Clients Benefit Equally to in-Person Counselling

Reading Psychology at a Distance: Examining the Efficacy of Online Therapy, by Ryan Baird Thompson at Portland State University, I was reassured to hear that the efficacy of counselling and psychotherapy, from the point of view of the clients, is unaffected by the medium (ie online rather than in-person). I have found this to be the case so far.

The study mentions that although clients report equal benefit, some clinicians interviewed were “unnerved by the possible loss of valuable non-verbal information, like body-language.” I have found that I have become more attuned to facial expression and hand gestures in online video sessions, the frame being limited to head and shoulders. It is however, harder to make out details such as eyes tearing up or a flushed face.

The report also cautions that the sample sizes were limited and further research is required, including that on how different modalities of therapy are affected by online work.

The Future of Online Therapy, Computers in Human Behaviour (2014) lists myriad concerns including technical glitches, delays in signal and fuzzy image - all of which clients and I have experienced at times and needed to negotiate. Some concerns about physical distance and building the therapeutic alliance remotely are countered by Amichai-Hamburger & Hayat (2013) and Hamburger & Ben-Artzi, (2000) who found that participants felt the internet to be a ‘secure arena’ which may facilitate self-disclosure and honesty.

Other benefits include increased accessibility for people with disabilities or living in remote areas. I have been pleased to be able to refer clients to colleagues I trust across Yorkshire now, rather than just the local area, and to have received referrals from colleagues in Leeds, Dewsbury and Garforth. It can also maximise the client’s time, without a commute.

The efficacy of web-based therapy has been assessed by a large number of trials for a variety of mental health concerns, including insomnia, depression, anxiety disorders and alcohol and substance abuse.

I continue to learn more as I study for my Certificate in Online and Phone Counselling, necessitated by the switch to these methods during Covid-19 restrictions.

Rachel Lackey